POSTPARTUM PSYCHOSIS - RISK FACTORS AND AETIOLOGY: A REVIEW (ID 1224)

Presentation Topic
AS58 Perinatal Disorders
Presenter
  • Inês V. Valada (Portugal)
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https://us04web.zoom.us/j/78908387622?pwd=c1VGRmFGRDQ4WW1MbGJKb2hOdFNCQT09
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Oct,18th 5:00h PM
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Abstract

Objectives

To summarise the evidence regarding proposed risk factors and aetiology of Postpartum Psychosis (PP).

Methods

We performed a literature review on the risk factors and aetiology of PP using the PubMed and Scopus databases.

Results

PP is a severe psychiatric disorder affecting approximately 1-2 of every 1000 women shortly after childbirth. Most episodes have their onset within 2 weeks of delivery and may last 1 week to several months without treatment. It is characterised by the sudden onset of delusions, hallucinations, mood swings, confusion, perplexity, agitation, and disorganised behavior. Affected individuals may be at increased risk of harming themselves or their offspring. The best-established risk factors for PP are a history of bipolar disorder or previous PP episodes. Other risk factors found in our review are primiparity, certain neuroimaging findings, such as larger ventricular and cisternal volumes and steroid sulfatase enzyme deficiency. The underlying mechanisms by which PP occurs are poorly understood. Studies to date have implicated immunological dysregulation, with a notable overactivation of the monocyte and macrophage lineages and imbalance between proinflammatory and immunosuppressive mediators; neuroendocrine factors related to oestrogen dropping; circadian rhythm disruption and genetics.

Conclusions

The evidence regarding the aetiology and risk factor for this condition is still scarce. Most mechanisms proposed to play a role in the genesis of PP have not been completely clarified and further research is vital. Understanding the pathophysiology of PP is crucial for identifying novel therapeutic targets and predictive biomarkers for identification of ‘at risk’ women facilitating earlier clinical interventions.

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